Introduction

Spirochete (spiral) bacteria belonging to the genus Leptospira are responsible for causing Leptospirosis.
It is the commonest zoonotic disease (i.e. animal disease that can be transmitted to humans), and affects mammals, birds and reptiles alike.

Humans contract this infection via direct contact with infected animals, or infectious animal tissues or fluids. Unhealed cuts and scratches form the entry points for the bacteria. Ingestion of contaminated food and water is another mode by which the disease spreads to humans.

The disease has a greater incidence in regions that experience heavy rainfall. Though it affects both men and women of all ages, it is commonly observed in middle-aged men.

Etio-patho-genesis (Causes and Mechanisms)

As stated before, Leptospira bacteria are the causative agents of the disease. The pathogen affects both animals and humans. It has a greater prevalence in regions that receive heavy and frequent rains. Such weather condition is favorable for its growth.

Mode of transmission

Leptospirosis usually spread via consumption of water contaminated by an infected animal’s excreta and body fluids, e.g. sweat, urine, feces, semen, etc Muddy riverbanks, ditches and lakes are the common sites of such contamination because of their frequent use by animals.

Mice are the primary hosts, i.e. they are the first to be infected by the bacteria. They act as carriers of the disease, and transmit it further.

Humans are infected by the bacteria when they are exposed to infected animals, or their body fluids or tissues. Splashing contaminated water into the eyes, the nose and open wounds, and consuming food or water infected by animal excreta are ways by which Leptospirosis is transferred to humans. It is not known to spread from one person to another.

Risk Factors

Individuals who are exposed to infected animals, e.g. veterinarians, pet-shop owners, people working at a slaughter house, etc.

Open wounds, as infected pets can lick them

Areas with high probability of infection such as muddy banks and gullies, especially during the rainy season

Presentation (Signs & Symptoms)

In case of humans, about 1-2 weeks elapse between the initial exposure and the appearance of the first symptoms (incubation period). Leptospirosis is biphasic, i.e. the disease re-manifests itself after an apparent resolution of the initial symptoms. The presentations in the second phase of the disease are generally more severe than earlier ones.

Investigations

Bacterial culture: Leptospira bacteria remain in the blood of the host for 7-10 days post exposure. After 10 days of initial exposure, the pathogen is visible in the urine as well. Thus, blood and urine samples are used for growing the bacteria in controlled laboratory conditions.

Kidney function and liver function tests help check for the effect of the disease of the functioning of the respective organs.

Kidney biopsy (involves examining a sample of nephritic tissue)

ELISA (Enzyme-linked Immunosorbent Assay), PCR (polymerase chain reaction) and MAT (microscopic agglutinations test) help detect the presence of specific antibodies. These antibodies are the proteins which are produced by the body’s defense system in response to the infection or foreign bodies.

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